Through this work, Rizzo champions the idea that placing patients in relatable video game-like scenarios can be beneficial in helping them engage with treatment. "I was working with brain injured patients back in the 1980s and 90s and finding that it was hard to engage them in this repetitive drill and practice brain training work," says Rizzo. "But when you deliver that kind of stuff in a brain-like context—like having them play SimCity, which is an engaging game but requires executive function, multi-tasking, memory, attention all brought together—all of sudden you see patients that you couldn't motivate for more than ten minutes now deeply engaged in a cognitive activity. With the PTSD work, that's one element, and it's a well-matched one for VR."
"PTSD and anxiety disorders are characterized and propagated by avoidance—[but then] the brain of that person doesn't learn."—Albert Rizzo
"Now, we're all finally here looking at VR running off a mobile phone, and looking at high-fidelity headsets like the Oculus or a Vive that blow away the head mounts of ten years ago, that cost tens of thousands of dollars," says Rizzo. "So, we've got the technology, and we've got 20 years of research documenting it all. When a clinician can open their desk drawer and open up a headset like that, no computer, and just hand it to a patient and have a wireless connection so that their laptop or iPad or whatever device they're using can actuate the scenario and can collect the data of the interaction, now you've got a tool that by all intents and purposes should be very adoptable by any clinician."The other end of this financial scale saw the Canadian government purchase the latest version of Rizzo's Bravemind—a PTSD treatment program that began life as a total conversion mod for 2004's Full Spectrum Warrior, which includes a vibrotactile platform and a scent machine that simulates diesel fuel, garbage, and gunpowder—for $17,000 each in 2014. "To engage the user, sometimes that multi-sensory experience really adds a lot," says Rizzo. "The vibrotactile platform is a cheap circus trick that stimulates multi-modal sensation because it's very inexpensive—we're using four subwoofers that cost 50 bucks a piece, a little amplifier, and we run all the sound into it."
"Research shows that activating fear and anxiety, in a safe place, is the only thing that makes it go away."—Rizzo